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The role of attachment and dissociation in the relationship between childhood interpersonal trauma and negative symptoms in psychosis
Clinical Psychology & Psychotherapy ( IF 3.198 ) Pub Date : 2022-02-25 , DOI: 10.1002/cpp.2731
Amy Degnan 1 , Katherine Berry 1 , Charlotte Humphrey 1 , Sandra Bucci 1
Affiliation  

Negative symptoms have an adverse impact on quality of life and functioning in psychosis. Service users with psychosis have identified negative symptoms as a priority for their recovery. Despite this, there is a lack of effective and targeted psychological interventions for negative symptoms and their underlying mechanisms remain poorly understood. Childhood trauma is a robust risk factor for positive symptoms in psychosis, but the association with negative symptoms is less well established. Our aim was to examine the association between childhood interpersonal trauma and negative symptoms and the psychological mediators of this relationship. Two hundred and forty participants experiencing psychosis completed validated self-report measures of childhood trauma, attachment, dissociation, compartmentalization, and symptoms. Mediation analyses showed that disorganized attachment and dissociative experiences mediated the association between childhood trauma and negative symptoms, when analysed individually and in a combined model. Models adjusted for age and positive and depressive symptoms. Avoidant attachment and compartmentalization were independently associated with negative symptoms but not childhood trauma and thus were not significant mediators. Childhood trauma was not independently associated with negative symptoms. This paper is the first to present empirical data to support a model implicating attachment and dissociation as important psychological processes in the link between childhood trauma and negative symptoms. These exploratory findings suggest that it may be beneficial to consider these relationships in trauma-informed formulations and interventions. Further longitudinal research is required to establish causality and test theoretical models of mechanisms in the pathway to negative symptoms.

中文翻译:

依恋和解离在童年人际创伤与精神病阴性症状之间关系中的作用

阴性症状对精神病患者的生活质量和功能有不利影响。患有精神病的服务使用者已将阴性症状确定为他们康复的优先事项。尽管如此,对阴性症状缺乏有效和有针对性的心理干预,其潜在机制仍知之甚少。童年创伤是精神病阳性症状的重要危险因素,但与阴性症状的关联尚不明确。我们的目的是检查童年人际创伤和消极症状之间的关联,以及这种关系的心理中介。240 名患有精神病的参与者完成了关于童年创伤、依恋、解离、分隔和症状的经过验证的自我报告测量。中介分析表明,当单独分析和在组合模型中分析时,混乱的依恋和解离经历介导了童年创伤和消极症状之间的关联。模型根据年龄以及阳性和抑郁症状进行了调整。回避依恋和区室化与阴性症状独立相关,但与童年创伤无关,因此不是重要的中介因素。童年创伤与阴性症状无关。本文是第一个提供经验数据以支持将依恋和解离作为童年创伤与消极症状之间联系的重要心理过程的模型。这些探索性发现表明,在创伤知情的制定和干预措施中考虑这些关系可能是有益的。
更新日期:2022-02-25
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